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Management of Nutritional Complications

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The ASMBS Textbook of Bariatric Surgery

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Abstract

Weight loss surgery (WLS), including sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and biliopancreatic diversion with duodenal switch (BPD/DS), dramatically alters the intake, digestion, and absorption of both macronutrients (protein, carbohydrates, and fats) and micronutrients (vitamins and trace elements). This can be the result of restriction of the stomach’s capacity, hormonal alterations in appetite (i.e., changes in ghrelin, GLP-1, PYY, etc.), malabsorption, or a combination of these mechanisms. While the goal of surgery is to decrease caloric intake in an effort to lose weight, these operations can also result in significant nutritional deficiencies that may lead to severe complications such as anemia, metabolic bone disease, and neurologic/ocular disorders. Studies have demonstrated reduced levels of almost all of the vitamins and minerals in the bariatric population, including vitamins A, B6, B12 C, D, E, thiamine, folate, iron, zinc, and selenium (Aills er al. Surg Obes Relat Dis 4(5 Suppl):S73–108, 2008; Bloomberg et al. Obes Surg 15(2):145–54, 2005). Surgeries that induce intestinal malabsorption, such as the RYGB or BPD/DS, are more likely to be associated with nutritional deficiencies, but patients who have undergone restrictive surgeries such as the sleeve gastrectomy are also at risk. Healthcare professionals who care for the bariatric patient must familiarize themselves with the potential nutritional deficiencies associated with WLS, and this chapter will describe how to diagnose and treat these nutritional complications.

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Author information

Authors and Affiliations

  1. Department of Surgery, Weill Cornell Medical Center, New York-Presbyterian Hospital, New York, NY, USA

    Michael Choi

  2. GI Metabolic and Bariatric Surgery, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY, USA

    Liz Goldenberg & Alfons Pomp

Authors
  1. Michael Choi
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  2. Liz Goldenberg
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  3. Alfons Pomp
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Correspondence to Alfons Pomp .

Editor information

Editors and Affiliations

  1. Department of Surgery, Division of Gastrointestinal Surgery, University of California, Irvine Medical Center, Orange, CA, USA

    Ninh T. Nguyen

  2. Department of Surgery, The Ohio State University, Columbus, OH, USA

    Stacy A. Brethauer

  3. Bariatric and Minimally Invasive Surgery Division, Yale School of Medicine, New Haven, CT, USA

    John M. Morton

  4. Bariatric Surgery, Metabolic and Bariatric Care, CHI Memorial Hospital, Chattanooga, TN, USA

    Jaime Ponce

  5. Department of General Surgery, The Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, FL, USA

    Raul J. Rosenthal

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Choi, M., Goldenberg, L., Pomp, A. (2020). Management of Nutritional Complications. In: Nguyen, N., Brethauer, S., Morton, J., Ponce, J., Rosenthal, R. (eds) The ASMBS Textbook of Bariatric Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-27021-6_22

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  • DOI: https://doi.org/10.1007/978-3-030-27021-6_22

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-27020-9

  • Online ISBN: 978-3-030-27021-6

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